Lobbying Firm Activity Authorization

Government Code Section 86104

Form 602 Instructions

Part 1 of 5: Type of Lobbying Firm

Check One Box if Applicable

Government Code Section 82039.5

FPPC Regulation 18616.4

Part 2 of 5: Filer Information

Part 3 of 5: Authorization

If you are authorizing another lobbying firm to lobby on behalf of your firm's client(s), provide the name(s) of the client(s) below. (It is not necessary to complete the Nature and Interests section.)

Part 4 of 5: Verification

I have used all reasonable diligence in preparing this Statement. I have reviewed this Statement and to the best of my knowledge the information contained herein is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Sign document after printing.

Part 5 of 5: Nature and Interests of Lobbyist Employer

Type of Lobbyist Employer

Part A. Individual

Part B. Business Entity

C. Industry, Trade, or Professional Association

3. Number of Members in Association (Check Appropriate Box)

Part D. Other

Part E. Industry Group Classification

Check one box which most accurately describes the industry group which you represent.

Business (Check one of the following sub-categories)

Please press 'Create PDF Document' button below. Filled out Form 602 PDF document will be opened. Please print the document and sign at the bottom of the page.

End of Page, Form 602